Children affected by PANS/PANDAS develop mental health symptoms literally overnight after being sick. Strep is the most common illness that those who have heard of PANS or PANDAS think of, but there are more illnesses besides strep that can trigger these reactions. PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections. This is the condition associated with strep. 

PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome. PANS can be caused by other forms of infection and metabolic issues. The common thread is that both are autoimmune and cause inflammation in the brain (encephalitis). This means that the antibodies that normally attack illnesses within our body attack our own body instead, and with PANS and PANDAS the area attacked is in the brain (basal ganglia). When the basal ganglia portion of the brain is impacted it affects a child’s thoughts, feelings and behavior

PANDAS is an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Strep Infections. PANS stands for Pediatric Acute-onset Neuropsychiatric Syndrome. PANDAS/PANS is a treatable autoimmune disorder that affects children with the average age of onset between 4 and 7 years. (It is possible that adolescents and adults may have immune mediated OCD, but this is not known.) The condition is believed to be triggered by an infection. PANDAS/PANS occurs when the antibodies the body has made to fight an infection mistakenly attack healthy tissue in the brain contributing to a host of movement disorders, neuropsychiatric symptoms, and abnormal neurologic behaviors. Parents often describe the onset of symptoms as the day they “lost” their child. Typically the change is dramatic, with symptoms developing within a 24 to 48 hour period. The OCD symptoms and/or eating restrictions begin so suddenly that most parents can recall the exact day and time that the OCD or restrictive eating began.

 Diagnosis & Treatment 

Often, PANDAS/PANS is misdiagnosed and only its symptoms are treated. To be effective, treatment must properly target the infection and support the underlying immune system. With proper medical care and appropriate medications, PANDAS/PANS can be successfully treated. Testing is the first step to proper diagnosis and treatment. 

Treatment for PANS/PANDAS generally involves blood tests (to diagnose the infection), antibiotics or other medicines for fighting infections (sometimes a long course), anti-inflammatory medicine (to reduce the swelling in the affected brain areas), and cognitive-behavioral or behavioral therapy (to address the emotional and behavioral symptoms as they do not tend to resolve with medical treatment alone). 

When the presentation involves Anxiety or OCD a form of CBT called exposure therapy is used to treat it. The form of exposure therapy used to treat OCD is called Exposure and Response Prevention (ERP). For tics and body-focused repetitive behaviors a form of behavioral treatment called Habit Reversal Training (HRT) is used. If problem behaviors are the main presentation behavioral treatments that heavily involve the caregivers such as Parent-Child Interaction Therapy (PCIT) or other forms of Parent Management Training (PMT) can be used.